title: Delayed arterial switch operation for d-transposition of the great arteries and glucocorticoid remediable aldosteronism.
abstract: The Jatene arterial switch operation (ASO) for dextro-transposition of the great arteries is ideally performed within the first 2 weeks of life. Clinical circumstances, however, may dictate a delayed ASO and left ventricle "retraining" prior to the procedure. Glucocorticoid remediable aldosteronism (GRA) accounts for 0.5% to 1% of primary aldosteronism. It presents as severe hypertension in infants and children, with poor response to standard antihypertensive medications. To the authors' knowledge, this is the first reported case of GRA in the context of transposition physiology. The management of GRA and a rationale for delayed ASO are discussed.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Nofil
authors.initials: N
authors.lastname: Arain
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Braunlin
authors.forename: James St
authors.initials: JS
authors.lastname: Louis
authors.forename: Roosevelt
authors.initials: R
authors.lastname: Bryant
keywords: arterial switch operation; comorbidity; congenital heart surgery; endocrinology; preconditioning